• Title/Summary/Keyword: Intractable

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High Spinal Block for Chronic Intractable Pain -A case report- (만성 난치성 통증의 치료를 위한 상위척수차단 -증례보고-)

  • Jeong, Mi-Hyang;Hong, Jin-Kyung;Lee, Cheol;Lee, Cheol-Seung
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.403-406
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    • 1996
  • Total spinal block is used as final choice for chronic intractable pain which doesn't respond to other treatments. A 35 years old male patient was admitted to pain clinic due to severe cramping and throbbing pain of whole body, especially left lateral side since 1980. The result of cervical and lumbar epidural block was not good enough, so we decided to try total spinal block. At first, C7-T1 interspace was punctured and 2% mepivacaine 20 ml was injected, but the result was not satisfied. Next day, L3-4 interspace was punctured and 1.5% mepivacaine 40 ml was injected. The sensory block level was C6 and pain score on Visual Analog Scale, was changed from 9 to 4. In both trials, actually even though they were not complete total spinal block, the effect was good enough. If complete total spinal block had been accomplished, better result might be obtained in this chronic intractable pain.

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A Case of Thoracoscopic Splanchnicectomy for Relief of Intractable Pain in Pancreatic Cancer -A case report- (췌장암 환자에서 난치성 통증에 대한 흉강경을 통한 내장신경 절제술 -증례 보고-)

  • Kim, Do Hyung;Shim, Je Kwang;Moon, Jin Chun;Yoon, Kyung Bong;Kim, Won Oak;Yoon, Duck-Mi
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.111-114
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    • 2006
  • Pancreatic cancer often elicits intractable abdominal pain which has significant negative impact on the quality of life in patients. Various therapeutic modalities including celiac plexus block are being used to alleviate the pain. The anatomic location of the pancreas often hinders the spread of anesthetic or neurolytic solutions by obliterating the retrocrural space, thus making the classic retrocrural approach unsuccessful. The following case describes a patient with intractable abdominal pain originating from advanced pancreatic cancer, which could be managed successfully with thoracoscopic splanchnicectomy after retrocrural celiac plexus block had failed.

Management of the Intractable Huge Intracranial Osteoma Based on the 3D Printing Model

  • Choi, Jong-Woo
    • Journal of International Society for Simulation Surgery
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    • v.3 no.2
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    • pp.77-79
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    • 2016
  • Osteoma is one of the benign tumor that occurs on the bones all over the body. Mostly the simple excision is known to be enough. However, sometimes we encounter the troublesome situation where the osteoma is located in very challenging area, which results in the recurrence. 26 year female presented with the intractable intracranial osteoma. Given the disease entity of the osteoma, the simple excision would be enough or conservative management. But this osteoma turned out to be huge and recurrent in spite of the endoscopic resections, which causes the facial disappearance accompanied by the orbital vertical dystopia. Moreover, the patient's main concern was the pain. We performed the intracranial resection of the whole lesion and reconstructed the skull base and frontal bone as well as the part of the orbital wall. In order to restore the original bony anatomy, the 3D printing model was used based on the titanium mesh. I report this unusual case of the intractable intracranial huge osteoma. This report may be helpful for the other surgeons to make a decision on their similar cases in the future.